目的 探讨麝香通心滴丸联合美托洛尔治疗冠心病心绞痛的临床疗效和安全性。方法 选取2015年12月—2017年1月上海市浦东医院收治的冠心病心绞痛患者90例，随机分为对照组和治疗组，每组各45例。对照组患者口服酒石酸美托洛尔缓释片，5 mg/次，2次/d，依据患者耐受程度和病情逐渐加量到10～25 mg/次，2次/d。治疗组在对照组的基础上口服麝香通心滴丸，2丸/次，3次/d。两组患者治疗时间均为2个月。观察两组患者临床疗效，比较治疗前后两组患者心电图疗效、心绞痛持续时间和发作次数、ST段及不良反应情况。结果 治疗后，对照组临床有效率和心电图疗效分别为77.7%和75.6%，均分别低于治疗组的93.3%和95.6%。两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者心绞痛持续时间和发作次数及ST段均显著降低，同组比较差异具有统计学意义（P<0.05）；且治疗组上述指标改善后水平显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗中，治疗组不良反应发生率为4.4%，明显低于对照组的13.3%，两组比较差异具有统计学意义（P<0.05）。结论 麝香通心滴丸联合美托洛尔治疗冠心病心绞痛临床疗效显著，有助于减少心绞痛发作次数和持续时间，安全性高，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy and safety of Shexiang Tongxin Dropping Pills combined with metoprolol in treatment of coronary heart disease with angina pectoris. Methods Patients (90 cases) with coronary heart disease and angina pectoris in Shanghai Pudong Hospital from December 2015 to January 2017 were randomly divided into control and treatment groups, and each group had 45 cases. Patients in the control group were po administered with Metoprolol Tartrate Sustained-release Tablets, 5 mg/time, twice daily, and the dosage was increased to 10-25 mg/time based on patient's tolerance and condition. Patients in the treatment group were po administered with Shexiang Tongxin Dropping Pills on the basis of the control group, 2 pills/time, three times daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacy was evaluated, and the electrocardiogram efficacy, the frequency and duration of angina pectoris, ST segment, adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical and electrocardiogram efficacy in the control group were 77.7% and 75.6%, which were significantly lower than 93.3% and 95.6% in the treatment group, respectively, and there were differences between two groups (P < 0.05). After treatment, the frequency and duration of angina pectoris, ST segment in two groups were significantly decreased, and there were differences in the same group (P < 0.05), and these indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). During the treatment, the incidence of adverse reactions in the treatment group was 4.4%, which was significantly lower than 13.3% in the control group, with significant difference between two groups (P < 0.05). Conclusion Shexiang Tongxin Dropping Pills combined with metoprolol has significant clinical effect in treatment of coronary heart disease with angina pectoris, which is conducive to reduce the frequency and duration of angina pectoris, with good safety, which has a certain clinical application value.

上海市浦东新区卫生系统学科带头人培养计划（PWRd2013-06）